Thoracic and Thoracoabdominal Aneurysm Repair: Is Reimplantation of Spinal Cord Arteries a Waste of Time?

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“…LR between 1 and 2 and between 0.5-1 rarely alter pretest probability. 6 Despite traditional spinal IOM literature suggests that NIOM is effective in identifying patients at a high risk for sustaining new spinal cord injuries [7][8][9][10][11][12][13][14][15] as well as animal research has supported human experience, [16][17][18] there is a heterogeneity in IOM services and this should be reviewed to see what accounts for the difference in false-positive and false-negative cases in the literature.…”

MR Angiography for Detecting the Artery of Adamkiewicz and Its Branching Level from the Aorta

“…It is still controversial that the collateral vessels can feed blood into the spinal cord, 13,15 and occlusion of the artery of Adamkiewicz may not be the only causative factor aŠecting spinal ischemia. 16 However, actual cases of spinal cord ischemia after endovascular repair of the aorta continue to be reported, 17 and increase in biochemical markers of ischemic spinal cord injury was documented in an experimental canine study of stent-graft implantation at a critical aortic segment. 18 Our study demonstrated that the artery of Adamkiewicz can be detected at a high rate preoperatively, allowing evaluation of the risk of occlusion of this artery, which could aŠect the likelihood of spinal complications.…”

Rehabilitation for Spinal Cord Injury Caused by Thoracic Aortic Aneurysm

“…A group from Mount Sinai Hospital discussed avoiding back-bleeding through the intercostal and lumber arteries, in order to prevent loss from the collateral circulation to the spinal cord, by sacrificing the segmental arteries before opening the aneurysm. As a result, the postoperative paraplegia rate in their series was 2% (Etz et al, 2006). However, when more than 10 arteries were sacrificed, the risk of paraplegia increased 29 fold (Gripp et al, 1996).…”